实用临床医药杂志2024，Vol.28Issue(17)：20-26,7.DOI:10.7619/jcmp.20241893
结直肠癌患者营养不良的影响因素及列线图预测模型的价值
Influencing factors of malnutrition in patients with colorectal cancer and value of Nomogram prediction model
摘要
Abstract
Objective To analyze the risk factors of malnutrition in patients with colorectal cancer(CRC)and construct a Nomogram prediction model.Methods A total of 402 hospitalized CRC patients in the Anning First People's Hospital Affiliated to Kunming University of Science and Technology from July 2021 to December 2023 were selected as research objects.The Global Leader-ship Initiative on Malnutrition(GLIM)criteria was used as the diagnostic criteria for malnutrition,and patients were divided into malnutrition group and well-nourished group.A multivariate Logistic regression model was used to analyze the influencing factors of malnutrition in CRC inpatients.A No-mogram prediction model was constructed based on predictive factors,and the discrimination and accuracy of the model were validated by the receiver operating characteristic(ROC)curve and Hosmer-Lemeshow goodness-of-fit test.Finally,the clinical application value of the model was verified by calibration curves and clinical decision curves.Results Among the 402 CRC patients,111 cases had malnu-trition,with a malnutrition rate of 27.61％.There were significant differences in age,tumor stage,long-term bedridden status,the Karnofsky Performance Scale(KPS)score,body mass index(BMI),the Nutritional Risk Screening 2002(NRS-2002),red blood cell(RBC),white blood cell(WBC),hemoglobin(HGB),albumin(ALB),prealbumin(PAB),alanine aminotransferase(ALT),and urea levels between the malnutrition and well-nourished groups(P＜0.05).Multivari-ate Logistic regression analysis showed that age,tumor stage,long-term bedridden status,HGB,KPS score,and PAB were independent risk factors for malnutrition in CRC patients,and the sensi-tivity,specificity and area under the curve(AUC)of the Nomogram prediction model constructed based on these factors were 57.4％,88.0％and 0.821(95％CI,0.773 to 0.870,P＜0.001)re-spectively.Based on internal validation,1 000 samples were drawn by the Bootstrap self-sampling method,with a consistency index of 0.821.The calibration curve and clinical decision curve indica-ted that the Nomogram prediction model had good clinical application value.Conclusion The No-mogram prediction model constructed on 6 factors such as advanced age,TNM classification of stageⅣ,poor KPS score,long-term bedridden status,decreased HGB and decreased PAB has a high predictive value for the risk of malnutrition in CRC patients.关键词
结直肠癌/风险因素/营养不良/列线图预测模型/长期卧床/前白蛋白Key words
colorectal cancer/risk factors/malnutrition/Nomogram prediction model/long-term bedridden status/prealbumin分类
医药卫生引用本文复制引用
陈春梅,张蓉,楚杰,王雪星..结直肠癌患者营养不良的影响因素及列线图预测模型的价值[J].实用临床医药杂志,2024,28(17):20-26,7.基金项目
昆明市卫生健康委员会卫生科研课题项目(2023-03-10-020) （2023-03-10-020）
